Provider Demographics
NPI:1790656205
Name:A&P SISTERLY UNITED
Entity type:Organization
Organization Name:A&P SISTERLY UNITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEITE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:203-685-1238
Mailing Address - Street 1:1355 RESERVOIR AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-2502
Mailing Address - Country:US
Mailing Address - Phone:203-753-7586
Mailing Address - Fax:
Practice Address - Street 1:1355 RESERVOIR AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-2502
Practice Address - Country:US
Practice Address - Phone:203-753-7586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty